HIV Self-Test Pre Survey
By agreeing to participate in the Georgia Home Self-Test Project, I acknowledge the following:

  • Testing is voluntary and can be done confidentiality at a public testing center.

  • Georgia law [O.C.G.A ? 31-22-9.2] protects the confidentiality of HIV test results and other related information .

  • Georgia law [O.C.G.A ? 31-22-9.2] prohibits discrimination based on an individual's HIV status and services are available to
         help with such consequences.
  • I agree to complete an HIV test. If the results are positive or if the test does not work properly, I understand that additional testing is required to confirm results. I also agree to be contacted by a local District Counselor to determine next steps and to help navigate HIV prevention and care needs.

    12a.When was your last HIV test?
          
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    Date of Survey: 02-FEB-23
          
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    Date of Survey: 02-FEB-23